Family relationships and depressive symptoms among Chinese older immigrants in the United States

Background: Given the growth in the number of older Chinese immigrants in the United States and the importance of family support in Chinese culture, this study examines how supportive and negative relationships with family members (children and spouse) influence depressive symptom severity among this population. Methods: Using data from the Population Study of Chinese Elderly in Chicago, we carried out multivariate negative binomial regression analysis using a sample of 3,159 Chinese older immigrants. Depressive symptom severity was measured using the Patient Health Questionnaire. Intergenerational and marital relationships were characterized using self-reported measures of two supportive features (confiding and aiding) and two negative features (demanding and criticizing). Results: Confiding and aiding relationships with children (incident rate ratio [IRR] = .70, confidence interval [CI]: 0.57, 0.85; IRR = .70, CI: 0.56, 0.88, respectively) and spouses (IRR = .61, CI:0.47, 0.79; IRR = .66, CI: 0.52, 0.83, respectively) were significantly associated with lower depressive symptom severity among the older Chinese immigrants sampled. Demanding (IRR = 1.39, CI: 1.16, 1.68) and criticizing (IRR = 1.37, CI: 1.17, 1.60) intergenerational relationships significantly predicted higher depressive symptom severity, and spousal criticism (IRR = 1.41, CI: 1.24, 1.59) was related to higher depressive symptom severity. Aiding relationships with children appears to be more important for older women than men (IRR = .69, CI: 0.47, 1.01). Conclusions: The findings reveal the importance of both positive and negative interactions with spouses and children in shaping mental well-being among older Chinese immigrants. Future geriatric practice and research should consider both supportive and negative features in examining and addressing interpersonal relationships and mental health.